Screening

What You Should Know Before You Decide About Prostate Cancer Testing

There are two tests used to help doctors screen for prostate cancer. They are:

Prostate-Specific Antigen (PSA) blood test

Digital Rectal Exam (DRE)

Prostate-specific antigen (PSA) is a protein produced by cells of the prostate gland. The PSA test measures the level of PSA in the blood. A doctor or nurse takes a blood sample and the amount of PSA is measured in a laboratory.

It is normal for men to have a low level of PSA in their blood. Higher levels of PSA can indicate either prostate cancer or benign (not cancerous) issues in the prostate. As men age, both prostate cancer and benign prostate conditions become more common. The most frequent benign prostate conditions are prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH) or enlargement of the prostate. There is no evidence that prostatitis or BPH causes cancer, but it is possible for a man to have one or both of these conditions and to develop prostate cancer as well.

The U.S. Food and Drug Administration (FDA) approved the use of the PSA test along with a digital rectal exam (DRE) to help detect prostate cancer. During a DRE, a doctor inserts a gloved finger into the rectum and feels the prostate gland through the rectal wall to check for bumps or abnormal areas. Doctors often use the PSA test and the DRE as prostate cancer screening tests. Your doctor might do a PSA blood test alone, or he might do both tests. These tests can help doctors detect prostate cancer inmen who have no symptoms of the disease.

A man’s PSA level and DRE status may not give doctors enough information to distinguish between cancer and benign prostate conditions. However, the doctor will consider the results of these tests when deciding whether to check further for evidence of cancer. Only a biopsy can diagnose prostatecancer. During a biopsy, samples of prostate tissue are removed by a needle and viewed under a microscope.

How to address prostate cancer presents a complicated public health problem. The disease is common in men, and a man has a one in seven chance of developing the disease in his lifetime. Prostate cancer is the second leading cause of cancer death among U.S. men; but when detected and treated in the early stages of the disease, before symptoms are present, five year survival rates are well over 90 percent. Over the past 2 decades in the United States, death rates for prostate cancer have fallen 45%, largely due to early detection and/or improved treatment.

However, not all prostate cancer is life threatening. There are many cases where a man with prostate cancer lives the duration of his life without symptoms from the disease. Research on distinguishing aggressive, life threatening disease from harmless, indolent tumors is ongoing,[ and there are many new tests on the market that examine the] .

Because of the difficulty of distinguishing between aggressive and indolent prostate cancer, there is currently no consensus in the medical community on whether men should be routinely screened for prostate cancer. However, there is one area of agreement—men should have an open and honest discussion on the benefits and risks of screening and make the decision they feel is best for them.

APCF Collaborates with Local Partners for Education/Screening Programs

APCF offers an education and screening program in communities across the state. The service is designed to offer prostate health education using an informed decision-making model and timely detection of (aggressive)prostate cancer. The program is free to men who do not have a prostate cancer diagnosis and are between ages 45 and 70.

APCF events are made possible through collaborations with local partners and medical volunteers. Local partners help APCF establish screening events by scheduling facilities, soliciting medical volunteers from the local community (phlebotomists to draw blood for the PSA test, physicians or advance practice nurses to perform DREs), and pre-registering men for screening.

At these events, APCF conducts education on informed decision-making, performs administration of the screening, and provides all medical supplies as well as access to laboratory services through a partnership with Baptist Health (support from other laboratory providers may also be secured where available). After events, APCF analyzes lab reports by reference to the Guidelines for Early detection of Prostate Cancer established by the National Comprehensive Cancer and notifies men by mail of their screening results with recommendations on follow up steps if needed. For men with suspicious test results, the APCF Patient Navigator will make direct contact to explain test results, answer questions, and advise urological consult if more investigation is warranted. [Click to see patient help]

How to Set Up an Education/Screening Program

Local partners who are interested in scheduling an education/screening program or a prostate health education program without a screening component in their community are encouraged to complete the Service Request Form and review the APCF Guidelines on creating an event.